Lumbar Spine Assessment

Question 1

Fryette’s law

Answer 1

1. in neutral SB opposite to rotation
2. In felxion/extension SB same side as rotation
3. movement in 1 plane decreases movement in others

Question 2

type 1 dysfunction

Answer 2

found in neutral position
multi segment >3
adaptive : repetitive mvt, imbalances, tightness
corrected in both flex or ext

Question 3

type 2 dysfunction

Answer 3

1 segment
traumatic
likes flex FRS
likes ext ERS
corrected in what they like

Question 4

facet info with law 1 and 2

Answer 4

same facet as side bend is closed

Question 5

how common is low back pain

Answer 5

80%

Question 6

what can influence the onset of LBP

Answer 6

environmental and personal factors
psychosocial causes

Question 7

risk factors for LBP (psychosocial) (6)

Answer 7

low educational status
stress
anxiety
depression
job dissatisfaction
low levels of social support in the workplace

Question 8

most common form of back pain

Answer 8

non-specific

Question 9

several structures can be the cause of the pain

Answer 9

true

Question 10

history taking for LBP should include

Answer 10

questions on substance exposure
detailed health history
work
habits
psychosocial factors

Question 11

is it recommended to do imaging within the first 6 weeks

Answer 11

no unless red flags

Question 12

Lumbar spine pathologies

Answer 12

Stenosis
spondylosis
spondylolisis
ankylosing spondylitis
biomechanical restrictions

Question 13

stenosis

Answer 13

narrowing of vertebral space
Better with flexion

Question 14

spondylosis (DDD)

Answer 14

begins in 20’s
overall OA and stenosis
age related wear and tear

Question 15

spondylolisis

Answer 15

90% at L5/S1
excessive lordosis
posturale ache
tight psoas and hamstrings
stress fx or complete fx

Question 16

ankylosing spondylitis

Answer 16

inflammatory disorder of spine
morning stiffness
pain with exercise
leading to decrease vertebral movement, bones of spine can fuse

Question 17

radicular pain

Answer 17

evoked from inflamed or lesioned dorsal root or its ganglion

Question 18

radicular pain location

Answer 18

often back to butt down legs

Question 19

most common cause of radicular pain

Answer 19

disc herniation

Question 20

radiculopathy

Answer 20

impairs the conduction down a spinal nerve or its root

Question 21

radiculopathy affects

Answer 21

sensory changes, motor fibers, and possible reflexes

Question 22

can radicular pain occur without radiculopathy

Answer 22

yes

Question 23

most common disc pathology

Answer 23

posterior disc herniation

Question 24

Facet joints

Answer 24

large amount of free and encapsulated nerve endings that activate nociceptive fibers
Can be a cause of CLBP

Question 25

facet joint syndrome

Answer 25

responsible for up to 30% of chronic low back pain

Question 26

common complaints of facet joint syndrome

Answer 26

pain off to the side possible radicular symptoms pain increased with extension, rotation and SB and walking uphill worse when waking up or sitting for long periods

Question 27

cause of stenosis

Answer 27

inflammatory/scar tissue after spine surgery disc herniation thickening of ligaments osteophytes

Question 28

common S/S of stenosis

Answer 28

midline back pain radiculopathy eased with flexion sitting lying worse standing lumbar extension

Question 29

what can increase risk of DDD

Answer 29

diabetes

Question 30

S/S of spondylosis

Answer 30

general neck pain and stiffness can be associated with radiculopathy

Question 31

spondylolisthesis

Answer 31

anterior translation of the vertebral body relative to the other, and secondary to an abnormality of the pars interarticularis

Question 32

chief complaints of spondylolisthesis

Answer 32

can be asymptomatic gradual onset that is worsened with activity involving hyperextension or rotation of L/S radiculopathy can occur

Question 33

spondylolisthesis can affect load sharing

Answer 33

inc shearing forces higher sacral slope, pelvic tilt inc pressure on discs, facet joints, leading to DD muscle spasm of ES to protect

Question 34

differential diagnosis

Answer 34

Question 35

how do postural muscles react to injury

Answer 35

tightness in the form of spasms or adaptive shortening

Question 36

how do phasic muscles react to injury

Answer 36

atrophy

Question 37

difficulty sitting associated with

Answer 37

lumbar instability or muscle spasm

Question 38

discogenic pain

Answer 38

flexion for extended periods of time

Question 39

special tests for L/S (11)

Answer 39

SLR (1-5) Slump corssover sign/well leg raise (SLR 5) PKB valsalva quadrant test stork mckenzie side glide pheasant passive lumbar extension H and I

Question 40

Pain in back with SLR

Answer 40

most likely from disc herniation

Question 41

pain in leg with SLR

Answer 41

pathology causing pressure on neurological tissues more laterally

Question 42

SLR 1 nerve

Answer 42

sciatic and tibial

Question 43

SLR 2 nerve

Answer 43

tibial

Question 44

SLR 3 nerve

Answer 44

sural

Question 45

SLR4 nerve

Answer 45

common peroneal

Question 46

SLR 5 nerve

Answer 46

nerve root